# DR. KELLY LORA LEWIS

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** Yes

## Provider details

- **NPI number:** 1740447770
- **Gender:** F
- **Credential:** PH.D.

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 103T00000X | Psychologist | 1768 | KS | Yes |
| 103T00000X | Psychologist | 2006034117 | MO | — |

## Other

- **Enumeration date:** 05/19/2008
- **Last updated:** 11/14/2017